Dimensions of the Somatic Health Complaints Questionnaire (SHCQ) in a Sample of Myocardial Infarction Patients

Psychometric analysis of the Multidimensional Fatigue Inventory in a sample of persons treated for myocardial infarction

BACKGROUND AND PURPOSE

Fatigue after myocardial infarction is a frequent and distressing symptom in the early recovery phase. The purpose of this study is to psychometrically evaluate the Multidimensional Fatigue Inventory (MFI-20).

METHODS

The MFI-20 was evaluated using Rasch analysis.

RESULTS

The result showed that the MFI-20 can be used to obtain a global score reflecting an underlying unidimensional trait of fatigue; a transformation of the summarized raw scale scores into interval scale scores could be made. Also, 4 of the 5 original dimensions separately fitted the Rasch model.

CONCLUSIONS

Calculation of a global score increases the possibility of identifying persons experiencing fatigue after myocardial infarction, and using the MFI-20 dimension scores increases the possibility of determining each person's specific fatigue profile.

Fatigue two months after myocardial infarction and its relationships with other concurrent symptoms, sleep quality and coping strategies

AIMS AND OBJECTIVES

To explore fatigue levels two months after myocardial infarction and examine the associations with other concurrent symptoms, sleep quality and coping strategies.

BACKGROUND

Fatigue has been found to be the most frequent and bothersome symptom after myocardial infarction, influencing health-related quality of life negatively.

DESIGN

The present study was explorative and cross-sectional. The focus was on fatigue two months postmyocardial infarction, complemented with a comparative analysis of fatigue dimension levels.

METHODS

The sample included 142 persons (mean age 63 years), treated for myocardial infarction, who responded to a questionnaire package measuring fatigue, depression, health complaints (symptoms), sleep quality and coping strategies.

RESULTS

The main results showed that a global fatigue score two months postmyocardial infarction was associated with concurrent symptoms, such as breathlessness and stress, and coping strategies such as change in values, intrusion and isolation. In comparisons of present fatigue dimension levels (general fatigue, physical fatigue, reduced activity and mental fatigue) two months postmyocardial infarction with baseline measurements (first week in hospital), the results showed that levels of fatigue dimensions had decreased. In comparisons with levels of fatigue four months postmyocardial infarction in a reference group, we found lower levels of fatigue two months postmyocardial infarction.

CONCLUSION

The present findings indicated that postmyocardial infarction fatigue is lowest two months postmyocardial infarction. This may thus be the right time to identify persons experiencing postmyocardial infarction fatigue, as timely fatigue relief support may prevent progression into a state of higher levels of fatigue.

RELEVANCE TO CLINIC PRACTICE

Measuring fatigue two months postmyocardial infarction would enable healthcare professionals to identify persons experiencing fatigue and to introduce fatigue relief support. Tailored rehabilitation support should include stress management and breathlessness relief support. If maladaptive use of the coping strategies isolation and intrusion is observed, these strategies could be discussed together with the patient.

General self-efficacy and health-related quality of life after myocardial infarction

Fatigue after myocardial infarction (MI) has been found to be distressing. A person's self-efficacy will influence his/her health behavior and plays an active role in tackling illness consequences. This study investigated associations between fatigue, disturbed sleep, general self-efficacy, and health-related quality of life (HRQoL) in a sample of 145 respondents admitted to hospital for MI two years earlier. The aim was to identify the predictive value of general self-efficacy and to elucidate mediating factors between self-efficacy and HRQoL. General self-efficacy measured four months after MI was positively related to HRQoL after two years. In tests of indirect effects, fatigue meditated the effects between self-efficacy and the physical and the mental dimension of HRQoL, respectively. The indirect effect of disturbed sleep went through that of fatigue. To conclude, patients who suffer from post-MI fatigue may need support aimed at helping them increase their self-efficacy as well as helping them adapt to sleep hygiene principles and cope with fatigue, both of which will have positive influences on HRQoL.

Physical activity six months after a myocardial infarction

In the present study, we wished to explore physical activity in middle-aged patients 6 months after a myocardial infarction and to compare the patients' self-reported activity level with pedometric measures of footsteps/day. The sample comprised 89 patients with myocardial infarction, aged <or= 65 years. The self-report question showed that < 40% of the patients were engaged in at least 30 min of physical activity every day. The pedometric physical activity data showed a daily mean number of steps of 6719. The self-report question was correlated with the pedometric registration data. Among myocardial infarction patients, physical activity 6 months after the acute heart attack was insufficient in the majority of patients, both when evaluated with a self-report question and when evaluated with a pedometer. Efforts to increase physical activity after myocardial infarction are warranted.

Illness consequences after myocardial infarction: problems with physical functioning and return to work

AIM

This paper is a report of a study to explore health problems, physical and mental functioning, and physical activity in working-age patients after myocardial infarction, in order to assess the possible effects of these factors on return to work.

BACKGROUND

A diagnosis of myocardial infarction may discourage patients from continuing an active working life. Enabling myocardial infarction patients to return to work has benefits for both individuals and society.

METHODS

A convenience sample was recruited of 88 patients, <or=65 years of age, who had suffered a myocardial infarction. Assessments of employment, health-related quality of life and physical activity (footsteps per day) were conducted in 2005-2006, 4-6 months after myocardial infarction. To explore data and compare groups, t-tests were applied. Logistic regression analyses were performed to identify variables that best predicted return to work.

RESULTS

Differences were identified between individuals who were employed after myocardial infarction and those who were not. Those not in work scored lower on variables related to the physical dimension of health-related quality of life and on physical activity. Logistic regression revealed that a multivariate model including age, physical dimension of health-related quality of life and footsteps per day predicted return to work in 68% of all cases (R2=0.344).

CONCLUSION

Low physical health and low physical activity after myocardial infarction negatively affect returning to work. These findings stress the importance of clinical assessment of myocardial infarction patients' daily physical activity and physical functioning.